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男,68岁,阵发性胸闷3年,持续加重6小时后突发意识丧失。查体:BP40/20mmHg,双肺呼吸音清。心率32次/分,律齐,各瓣膜区未闻及杂音。血清肌钙蛋白水平增高。该患者意识丧失的最可能原因是()
A . A.心肌病
B . 主动脉夹层
C . 急性肺栓塞
D . 主动脉瓣狭窄
E . 急性心肌梗死
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